Low-carbohydrate diets in severely obese adults

Changes in atherogenic dyslipidemia and glycemic control are more favorable in severely obese patients on a low-carbohydrate diet than on a conventional weight loss diet, find researchers in the Annals of Internal Medicine.

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In this study, researchers from the United States compared the 1-year outcomes of weight loss and metabolic changes in obese adults on either a low-carbohydrate diet or a conventional weight loss diet.

The study included 132 obese adults with a body mass index of 35 kg/m2 or more.

Of the 132 participants, 83% had diabetes or metabolic syndrome.

Participants were instructed to either restrict carbohydrate intake to < 30 g per day or to restrict caloric intake by 500 calories per day with < 30% of calories from fat.

The research team measured changes in weight, lipid levels, glycemic control, and insulin sensitivity.

After 1 year, the mean weight change for the low-carbohydrate group was –5.1 kg, compared with –3.1 kg for conventional group.

Findings were limited by a 34% dropout rate.

Annals of Internal Medicine

The team found that triglyceride levels decreased more in the low-carbohydrate group, while high-density lipoprotein cholesterol levels decreased less.

In a group of 54 participants with diabetes, hemoglobin A1c levels improved more in the low-carbohydrate group.

The researchers caution that their findings are limited by a 34% dropout rate and by suboptimal dietary adherence of the enrolled persons.

Dr Linda Stern and colleagues concluded, "Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet".

"Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss".